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Sökning: WFRF:(Ryd G)

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  • Aad, G, et al. (författare)
  • 2015
  • swepub:Mat__t
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  • Fricke, Katrin, et al. (författare)
  • Fetal cardiac magnetic resonance imaging of the descending aorta in suspected left-sided cardiac obstructions
  • 2023
  • Ingår i: Frontiers in Cardiovascular Medicine. - 2297-055X. ; 10, s. 01-10
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Severe left-sided cardiac obstructions are associated with high morbidity and mortality if not detected in time. The correct prenatal diagnosis of coarctation of the aorta (CoA) is difficult. Fetal cardiac magnetic resonance imaging (CMR) may improve the prenatal diagnosis of complex congenital heart defects. Flow measurements in the ascending aorta could aid in predicting postnatal CoA, but its accurate visualization is challenging.Objectives: To compare the flow in the descending aorta (DAo) and umbilical vein (UV) in fetuses with suspected left-sided cardiac obstructions with and without the need for postnatal intervention and healthy controls by fetal phase-contrast CMR flow. A second objective was to determine if adding fetal CMR to echocardiography (echo) improves the fetal CoA diagnosis.Methods: Prospective fetal CMR phase-contrast flow in the DAo and UV and echo studies were conducted between 2017 and 2022.Results: A total of 46 fetuses with suspected left-sided cardiac obstructions [11 hypoplastic left heart syndrome (HLHS), five critical aortic stenosis (cAS), and 30 CoA] and five controls were included. Neonatal interventions for left-sided cardiac obstructions (n = 23) or comfort care (n = 1 with HLHS) were pursued in all 16 fetuses with suspected HLHS or cAS and in eight (27%) fetuses with true CoA. DAo or UV flow was not different in fetuses with and without need of intervention. However, DAo and UV flows were lower in fetuses with either retrograde isthmic systolic flow [DAo flow 253 (72) vs. 261 (97) ml/kg/min, p = 0.035; UV flow 113 (75) vs. 161 (81) ml/kg/min, p = 0.04] or with suspected CoA and restrictive atrial septum [DAo flow 200 (71) vs. 268 (94) ml/kg/min, p = 0.04; UV flow 89 vs. 159 (76) ml/kg/min, p = 0.04] as well as in those without these changes. Adding fetal CMR to fetal echo predictors for postnatal CoA did not improve the diagnosis of CoA.Conclusion: Fetal CMR-derived DAo and UV flow measurements do not improve the prenatal diagnosis of left-sided cardiac obstructions, but they could be important in identifying fetuses with a more severe decrease in blood flow across the left side of the heart. The physiological explanation may be a markedly decreased left ventricular cardiac output with subsequent retrograde systolic isthmic flow and decreased total DAo flow.
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10.
  • Hansson, Ulrik, et al. (författare)
  • Histologic reactions to particulate wear debris in different mesenchymal tissues : Studies on the nonreplaced compartment from revised uni-knees
  • 2004
  • Ingår i: The Journal of Arthroplasty. - : Elsevier BV. - 0883-5403 .- 1532-8406. ; 19:4, s. 481-487
  • Tidskriftsartikel (refereegranskat)abstract
    • The interface between bone and artificial-joint implants consists of soft tissue. This tissue varies from fibrocartilage to loose fibrous tissue. Tissues that resemble those can be found in normal joints. Sixteen knees with unicompartmental knee prostheses, revised because of excessive wear of the tibial insert, were studied. Synovium, synovial fluid, cartilage, and bone from the nonreplaced compartment were studied with light microscopy. We found wear particles and reactions to those in all tissues except cartilage. In the subchondral bone, we found osteolytic-like processes undermining the cartilage peripherally. Our conclusion from these findings is that the histologic composition of the bone-implant interface might be an important factor regarding the reaction of the tissue to wear particles and, thus, component fixation. © 2004 Elsevier Inc. All rights reserved.
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